The da Vinci Surgical System is a sophisticated robotic platform designed to enable complex surgery using a minimally invasive approach. The da Vinci System consists of an ergonomic surgeon’s console, a patient-side cart with four interactive robotic arms, a high-performance 3D HD vision system and proprietary EndoWrist® instruments. Powered by state-of-the-art robotic technology, the da Vinci System is designed to scale, filter and seamlessly translate the surgeon’s hand movements into more precise movements of the EndoWrist instruments. The net result is an intuitive interface with breakthrough surgical capabilities.
The da Vinci Surgical System’s main features include:
- Intuitive® motion, high-resolution 3D vision
- Innovative EndoWrist instrumentation
Intuitive motion refers to the System’s interface, which helps make da Vinci surgery look and feel like traditional “open” surgery. But this is where the similarities end.
The da Vinci robot system’s high-resolution 3D stereo viewer is designed to provide surgeons with an immersive experience. Unlike conventional approaches, the target anatomy appears at high magnification, in brilliant color and with natural depth of field. To perform a procedure, the surgeon uses the console’s master controls to maneuver the patient-side cart’s four robotic arms, which securely hold the patented EndoWrist instruments and high-resolution endoscopic camera. The EndoWrist instruments’ jointed-wrist design exceeds the natural range of motion of the human hand; motion scaling and tremor reduction further interpret and refine the surgeon’s hand movements. A final hallmark of the da Vinci System is its fail-safe design, incorporating multiple, redundant safety features designed to minimize opportunities for human error when compared with traditional approaches.
The da Vinci System is a remarkable improvement over conventional laparoscopy, in which the surgeon operates while standing, using hand-held, long-shafted instruments, which have no wrists. With conventional laparoscopy, the surgeon must look up and away from the instruments to a nearby 2D video monitor to see an image of the target anatomy. The surgeon must also rely on his/her patient-side assistant to position the camera correctly. In contrast, the da Vinci System’s ergonomic design allows the surgeon to operate from a comfortable, seated position at the console, with eyes and hands positioned in line with the instruments. To move the instruments or to reposition the camera, the surgeon simply moves his/her hands.
By providing surgeons with superior visualization, enhanced dexterity, greater precision and ergonomic comfort, the da Vinci Surgical System makes it possible for more surgeons to perform minimally invasive procedures involving complex dissection or reconstruction. This ultimately raises the standard of care for complex surgeries, translating into numerous potential patient benefits.
For the patient in Los Angeles, a da Vinci procedure can offer all the potential benefits of a minimally invasive procedure, including less pain, less blood loss and less need for blood transfusions. Moreover, the da Vinci System can enable a shorter hospital stay, a quicker recovery and faster return to normal daily activities. Clinical studies also suggest that the da Vinci System may help surgeons provide better clinical outcomes than conventional technologies allow — for example, better cancer control and a lower incidence of impotence and incontinence with da Vinci Prostatectomy.
Men who have been diagnosed with prostate cancer or benign prostatic hyperplasia (BPH) are often recommended to undergo prostate surgery to remove the cancerous or enlarged tissue, particularly when conservative treatments have been ineffective. While the prospect of surgery can be intimidating, the urological surgeons at Comprehensive Urology are highly skilled at performing minimally invasive robotic prostate surgery with the da Vinci® Surgical System, which is the most advanced surgical method of treating prostate conditions available.
If you or a loved one has been diagnosed with cancer of the prostate or BPH, the urologists at Comprehensive Urology can provide the thorough minimally invasive treatment necessary to prevent the problem from worsening and helping you return to your everyday life.
What is the da Vinci Surgical System?
The minimally invasive da Vinci robotic prostate surgery system uses cutting-edge technology to improve upon traditional open surgery techniques. The surgeon completely controls four interactive robotic arms from a computer console, which allows the surgeon to perform minimally invasive complex operations with precision and accuracy.
The da Vinci Surgical System received FDA approval in 2000 for both adult and pediatric urologic procedures, among others. The system is designed to perform the exact same movements of the surgeons hands, fingers, and wrists without the need for large incisions. The instrument arms are able to operate in 1-cm openings or operating ports in the patient’s abdomen for minimally invasive procedures.
Robotic Prostate Surgery Vs. Traditional Open Prostate Surgery
Unlike traditional surgery, the da Vinci surgical system is minimally-invasive as it needs only small incisions in which to operate. The high resolution 3D endoscope and high intensity illuminators offers high definition images for superior visualization, which greatly improve the surgeon’s ability to target malignant or targeted tissue, leaving surrounding muscle, tissue, and organs untouched.
Additional benefits of the minimally invasive da Vinci robotic-assisted surgery compared to traditional open surgery include:
- Smaller incisions
- Minimal scarring
- Improved preservation of healthy tissue and nerves
- Less post-operative pain
- Reduced risk of infections
- Shorter recovery times
- Less blood loss promotes faster healing
As with any surgical procedure, there are risks associated with robotic-assisted prostate surgery, which the urologists at Comprehensive Urology in Los Angeles discuss with each and every patient. It is our highest priority to deliver the best quality care possible while also ensuring that our patients are well-informed and confident in their care.
Types of Robotic Prostate Surgeries
The da Vinci robotic surgical system and similar robotic devices can be used to perform a variety of complex but minimally invasive operations, including the following common procedures for prostate conditions.
Robotic-Assisted Laparoscopic Radical Prostatectomy
Due to its safety and efficiency, robotic-assisted laparoscopic radical prostatectomy has become the most commonly used approach for surgically treating prostate cancer. The da Vinci procedure is particularly ideal for minimally invasive prostate surgery as the surgeon has such a high degree of control and precision that it is possible to protect vital nerves, ensuring that patients can typically maintain normal sexual and physical activity.
Robotic-assisted laparoscopic radical prostatectomy involves only five small incisions of no larger than 1.5 centimeters, through with the surgeon will be able to dissect and remove the prostate, then sew the bladder to the urethra without the surgeon’s hands ever having to enter the body. In some cases, depending on the patient’s condition, the lymph nodes may also be removed.
Robotic-Assisted Surgery for Benign Prostatic Hypertrophy (BPH)
For patients with benign prostatic hypertrophy, it is possible to remove portions of the enlarged prostate with minimally invasive da Vinci robotic-assisted surgery. This option is typically recommended after other procedures have proven ineffective or for patients who have severely enlarged BPH.
The placement of the incisions in the robot-assisted procedure will depend on the extent of the prostate’s size as well as the patient’s symptoms and overall health. The surgeon will make precise incisions in the prostate to remove abnormally enlarged portions and then sew the gland back together. In many cases, the urethra can be left untouched during the procedure reducing the risk of infection or damage.
Recovering from Robot-Assisted Prostate Surgery
Compared to standard open operations, most patients are able to recover from robotic prostate surgery in less time. Depending on the extent of the operation, patients can expect to spend one or two days in the hospital before returning home, rather than a week or more with traditional operations. Patients can also expect to experience pain and swelling, however, these symptoms can be managed with rest and pain medication.
The recovery process varies for each patient, however, the urologists at Comprehensive Urology are dedicated to ensuring that each and every patient has the best possible outcome following robotic prostate surgery and smoothest recovery.
Prior to robotic surgery, surgeons traditionally treated kidney cancer by removing the entire kidney, a procedure called nephrectomy. This involved making a large incision in the abdomen in order to access the kidney. Laparoscopy, another form of kidney removal, involved making several small incisions in the abdomen allowing the surgeon to operate through the openings. Although nephrectomy and laparoscopy have been effective in the past, the surgeon’s range of motion is limited when utilizing these two methods. Through robotic surgery using the da Vinci Surgical System, experienced surgeons are able to complete complex procedures with minimal incisions.
The da Vinci Surgical System at Comprehensive Urology
Fortunately, Comprehensive Urology in Los Angeles offers robotic surgery, the most advanced surgical approach for kidney cancer today. Not only is this type of surgery minimally invasive, it allows the surgeon to have better dexterity and finer hand control movements as well. At Comprehensive Urology, robotic surgery is performed through the da Vinci Surgical System, a sophisticated, minimally invasive robotic platform designed to enhance the surgeon’s capabilities and visualization. With the da Vinci Surgical System, miniaturized wristed instruments and a high-definition 3D camera are inserted through five or six small incisions in the abdomen. The platform allows the surgeon to be seated comfortably while being able to view the site of surgery inside a person’s body. Furthermore, the surgeon is able to intricately navigate through the site of surgery more seamlessly as the latest robotic and computer technologies filter and translate the surgeon’s hand movements into controlled micro movements.
Benefits of Robotic Surgery for Kidney Cancer
Today, more urologists are choosing robotic surgery for kidney cancer patients because they have come to recognize that it is best to remove only the cancerous part of the tissue while preserving as much of the normal kidney tissue as possible. This is especially beneficial for kidney cancer patients who have been diagnosed with diabetes or high blood pressure. Removing only the diseased part of the kidney in order to leave the patient with as much healthy kidney tissue possible is called a partial nephrectomy. It is recommended for patients who have kidney tumors less than four centimeters in size.
The beauty behind the da Vinci Surgical System used at Comprehensive Urology is that it allows the surgeon to perform all the steps of a partial nephrectomy, or any procedure for that matter, with precise movement and dissection. The tumor is identified and removed in the most minimally invasive way, which decreases the levels of stress on the patient’s kidney. Patients who undergo robotic surgery for kidney cancer typically have less pain, less scarring and fewer side effects than those who choose traditional procedures such as laparoscopy and radical nephrectomy.
If your doctor recommends that you or a loved one undergo robotic bladder surgery, whether to treat a urinary incontinence issue or bladder cancer, the prospect is probably more than a little intimidating. Fortunately, the expert urologists at Comprehensive Urology have extensive training and experience performing robotic-assisted surgical procedures, particularly with the da Vinci robotic surgical system. Robotic bladder surgery allows our urological surgeons to safely perform complex procedures with minimal incisions and improved recovery times.
How is Robot-Assisted Surgery Performed?
Minimally invasive robotic bladder surgery essentially involves using very small surgical tools that are attached to a robotic arm and computer station. The patient is given general anesthesia in order to sleep comfortably through the procedure without pain. With the robotic system, the urological surgeon only needs to make a few small incisions rather than the longer incisions that are typically used in traditional open surgery, which can involve cutting through muscle to reach the bladder.
One of the instruments that the surgeon will use is an endoscope, which is a thin tube attached to a camera that allows the surgeon conduct the operation with clear, 3D images. Additionally, the robotic arms are able to perform the smallest, most precise movements, achieving accurate results with minimal incisions or damage to surrounding tissues and nerves.
Types of Robotic-Assisted Bladder Operations
The da Vinci robotic surgical system and other similar devices can be used to perform a wide range of complex procedures, including the following common operations for bladder conditions.
Partial or Radical Cystectomy
In many cases of aggressive bladder cancer, it is recommend that a portion or the entire bladder be removed to prevent the disease from spreading to other parts of the body. Robotic-assisted cystectomy ensures that only the targeted tissues and cells are removed, reducing the risk of complications and blood loss considerably. Robotic bladder surgery is often advised for patients older than 60 who might not be eligible for traditional open cystectomy.
When the entire bladder is removed, the patient will need to undergo reconstructive surgery to create a surrogate bladder. In some cases, robot-assisted reconstructive surgery involves creating the following options:
- A stoma or opening in the abdomen to attach a disposable bag,
- A reservoir out of a section of the small intestine to store urine before it is emptied into an external pouch, or
- A neobladder out of a section of the small intestine that can be emptied with a catheter inserted through the urethra.
Using a da Vinci robotic system to perform minimally invasive reconstructive bladder surgery is ideal for many patients as it reduces the number of incisions involved in an already life-changing operation. Fewer incisions can make the recovery process quicker and easier.
For more information on robotic surgery, visit WebMD.com.
Robotic Bladder Diverticulectomy
Patients who have a bladder diverticulum, which is a small pouch or sac that develops in the bladder wall as a result of congenital factors, urinary blockage, or nerve damage, may require surgery. Treatment is not always necessary, however, minimally invasive surgery may be performed to remove any blockages and even the diverticulum if the patient is suffering from bladder stones, frequent urinary tract infections, bladder tumors, or urinary reflux.
What are the Benefits of Robotic-Assisted Bladder Surgery?
Minimally invasive robotic bladder surgery can provide a number of benefits over traditional open operations, including the following:
- Minimal incisions
- Lower risk of infections
- Reduced post-operative pain and scarring
- Less post-operative pain medicine
- Reduced risk of damaging erectile nerves
- Less blood loss
- Quicker recovery times
- Enhanced 3D visualization for the surgeon
As with any surgical procedure, there is a degree of risk with minimally invasive robotic bladder surgery. The team at Comprehensive Urology is dedicated to achieving the best possible outcome for each patient and strive to make our patients as comfortable and confident as possible before any procedure.
Prior to any minimally invasive treatment, we ensure that our patients are well informed about the advantages and disadvantages of treatment and what to expect in order to provide the best comprehensive care.
What to Expect During Recovery from Robotic Bladder Surgery
As a minimally-invasive procedure, most patients are able to heal and get back to their daily lives in less time than it would normally take with open surgery. Larger incisions pose greater risks of infection and greater post-operative pain, which can extend the recovery period by several days or even weeks, depending on the patient.
Patients may expect to use a catheter during the first several days depending on the type of operation and whether the bladder is still intact. Additionally, patients can expect to spend one to two days in the hospital following the surgery rather than a full week as with open surgery. Every patient is unique and the urologists at Comprehensive Urology adjust follow-up care and guidance accordingly. Our goal is to ensure the smoothest and most comfortable transition back to everyday life.
Varicocele is a condition in which the veins just above the testicles become swollen and inflamed, not unlike varicose veins that occur in the legs. While varicoceles may not cause any symptoms, it can impact a man’s sperm count and quality, interfering with his ability to have children. If you suspect you may have varicocele, do not wait to get examined by a skilled urologist, such as the team at Comprehensive Urology. Varicocele can become progressively worse over time, leading to pain and infertility, if left untreated.
Our exceptional urologists in Los Angeles are highly trained and compassionate, focusing on reaching the best possible outcome for each and every patient’s unique needs and circumstances.
What are the Signs of Varicoceles?
In many cases, some men do not experience any symptoms from varicoceles, but may not swelling or inflammation of the veins at the top of the testicles. The left side is usually affected, if not both sides. However, as the vein becomes more inflamed and engorged with blood, it may cause aching pain or a feeling of heavy weight within the scrotum, which may become more intense when standing for a long period of time.
Treating with Robotic Varicocelectomy
Depending on the extent of the varicoceles and a patient’s health and lifestyle, the condition may not require immediate treatment, however, it is crucial to have the condition evaluated by a skilled urologist to determine the best course of action. In the event that the swelling and inflammation worsens, minimally invasive treatment may be necessary.
At Comprehensive Urology, our professional urologists have extensive experience evaluating and diagnosing varicoceles, as well treating the condition with the latest, most effective techniques and technology. Robotic varicocelectomy is one of the most advanced, minimally invasive options available for alleviating the discomfort and reduced sperm quality associated with varicoceles. This minimally invasive surgical procedure is ideal for many patients because of the following benefits:
- Only small, minimally invasive incisions are needed in the groin or abdomen
- The da Vince Surgical System allows the surgeon to have a clear, 3-D view of the varicoceles without needing open surgery
- The robotic surgery gives the surgeon optimum control and precision
- Minimal incisions reduce pain and bleeding
- Patients experience a much smaller risk of scarring
- Recovery times are much shorter
- Less time spent in the hospital
For patients who have experienced a drop in sperm production and quality, a minimally invasive robotic varicocelectomy can help reverse the damaging affects of the inflamed veins leading to the testicles. By undergoing a minimally invasive procedure, you can prevent the condition from worsening and limiting your life choices in the future.
Is Robotic Surgery Right For You?
Although robotic surgery is considered a safe and effective minimally invasive treatment option for kidney tumors, it is important to remember that no two conditions are alike. It is best to fully discuss your options with an experienced urologist so that both of you can determine if minimally invasive robotic surgery is best for you. The Comprehensive Urology team in Los Angeles is one of the most specialized and experienced groups of urologists in minimally invasive robotic kidney surgery. If you would like to discuss your treatment options with the leaders in the field of urology and kidney cancer, call (310) 499-2756 today.
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